Joseph Jungwirth
Rock Island
Summary
Results-driven claims processing professional with extensive experience in reviewing and validating insurance claims, ensuring accuracy and compliance with industry standards. Strong focus on problem-solving and effective communication fosters collaboration within teams to adapt to evolving needs. Proficient in utilizing claims software, data entry, and delivering exceptional customer service. Recognized for reliability and consistently achieving results in dynamic environments.
My company is not renewing their contract and we are done April 20. I am ready to start as soon as possible.
Overview
18
18
years of professional experience
Work History
Claims Processor
Sutherland Healthcare Solutions
175 Sully's Trail, Suite 301, Pittsford, NY 14534
10.2024 - Current
- Processed insurance claims efficiently, ensuring compliance with regulatory standards.
- Reviewed and verified claim documentation for accuracy and completeness.
- Collaborated with healthcare providers to resolve discrepancies in claims submissions.
- Trained junior team members on claims processing procedures and best practices.
- Handled payments from patients
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Verified and added patients insurance to claims
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Followed up with customers on unresolved issues.
Fraud Specialist
US Bank
Rock Island, IL
09.2023 - 03.2024
- Working from home taking inbound calls and helping people who are experiencing fraud and resolve their issues or transfer them to the right department.
- Use a variety of different programs to find fraud and information about the customers account so i can get their account open.
- Take a high volume of calls everyday and get them done in a timely fashion and get all information needed to close the case properly.
- I still currently work at US Bank and am looking for a new opportunity.
- Analyzed transaction data to identify fraudulent activity and mitigate risks.
- Collaborated with cross-functional teams to develop fraud prevention strategies and best practices.
- Investigated complex cases of suspected fraud, documenting findings for compliance purposes.
Call Center Agent
Humach
Rock Island, IL
01.2020 - 01.2022
- Worked from home to assist customers via incoming and outbound calls to process cancellations and assist with tech issues.
- Provided basic technical support clarification to customers.
- Established relationships with customers as needed for ongoing support.
- Proficiently problem solved alongside customer for positive outcomes.
- Worked closely with team and managers to help solve customers problems.
Dock Worker
Old Dominion Freight
Rock Island, IL
01.2011 - 01.2018
- Loaded freight for customers.
- Loaded and unloaded trailers on a fork lift and pallet jack.
- Inspected and cleaned trailers at the beginning and end of shift.
- Drove a semi to load trailers into the docks.
- Did shipping and receiving and os&d and also weight and logged every piece of freight.
- Loaded and unloaded trailers, ensuring proper handling of cargo as per safety protocols.
- Operated forklifts and pallet jacks to efficiently move freight within dock area.
- Inspected shipments for damage and discrepancies, reporting issues to management promptly.
Data Entry Specialist
Rock Island Township assessment office
Rock Island, IL
01.2008 - 12.2010
- Gathered measurements of county properties including commercial and residential buildings.
- Managed and operated in house system for all property assessment activities.
- Organized and listed property of individuals and performed coding, keying, and editing.
- Used a program to draw and enter measurements of properties on the computer to store for assessments.
Education
High School Diploma -
Rock Island High School
Rock Island, IL05.2003
Skills
- Claims processing
- Insurance processing
- Medical coding
- Healthcare
- Financial transaction oversight
- Customer service specialist over 15 years experience
- Risk Level Determination
- Banking
- Fraud Detection
- Fraud and Anomaly Analysis
- Trained in Microsoft excel, word, teams and powerpoint
- Text editing
- Filing and Data Archiving
- Data Accuracy
- 50 wpm
- Work very well alongside others and is always eager to learn
Timeline
Claims Processor
Sutherland Healthcare Solutions
10.2024 - Current
Fraud Specialist
US Bank
09.2023 - 03.2024
Call Center Agent
Humach
01.2020 - 01.2022
Dock Worker
Old Dominion Freight
01.2011 - 01.2018
Data Entry Specialist
Rock Island Township assessment office
01.2008 - 12.2010
High School Diploma -
Rock Island High School